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Detection of Chlamydia pneumoniae by polymerase chain reaction-enzyme immunoassay in an immunocompromised population
C A Gaydos1, C L Fowler, V J Gill
1Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205-2196.
Abstract:
Chlamydia pneumoniae has now been associated with pneumonia, bronchitis, pharyngitis, acute chest syndrome of sickle cell disease, and asthma. Because of the difficulty of primary isolation and tissue-culture adaptation of this organism, we used a previously developed polymerase chain reaction-enzyme immunoassay (PCR-EIA) to screen 132 culture-negative bronchoalveolar lavage (BAL) specimens from 108 immunocompromised patients (34% of whom were positive for human immunodeficiency virus) and 7 healthy volunteers. Thirteen specimens (9.8%) from 12 immunocompromised patients (11.1%) gave a positive result; one patient had two positive specimens obtained 3 days apart. No healthy volunteer had a PCR-EIA-positive BAL specimen. Twelve (11.1%) of the immunocompromised patients also had diagnostic levels of antibody. Four patients had positive results in both PCR-EIA and serological tests. Thus 20 (18.5%) of the 108 patients had laboratory evidence of C. pneumoniae infection. These data indicate that diagnosis of acute infection with C. pneumoniae can be established more rapidly and reliably by PCR-EIA than by culture or serology, particularly among immunocompromised patients, in whom serological changes in response to infection are relatively undependable. With an infection rate of 11.1% according to PCR-EIA, C. pneumoniae should be considered in the evaluation and treatment of pneumonia in immunocompromised patients.
Insights
Chlamydia pneumoniae infections are linked to respiratory illnesses. A new PCR-EIA test offers faster, more reliable diagnosis in immunocompromised patients compared to traditional methods.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunocompromised Host Research
Background:
- Chlamydia pneumoniae is associated with various respiratory conditions, including pneumonia and asthma.
- Traditional diagnostic methods like culture are challenging due to difficulties in organism isolation and adaptation.
- Immunocompromised patients, including those with HIV, present unique diagnostic challenges for C. pneumoniae.
Purpose of the Study:
- To evaluate the utility of a polymerase chain reaction-enzyme immunoassay (PCR-EIA) for diagnosing Chlamydia pneumoniae infection.
- To compare the efficacy of PCR-EIA with culture and serology in immunocompromised patients.
Main Methods:
- A previously developed PCR-EIA was used to screen 132 culture-negative bronchoalveolar lavage (BAL) specimens.
- Specimens were collected from 108 immunocompromised patients (34% HIV-positive) and 7 healthy volunteers.
- Serological antibody levels were also assessed in the patient group.
Main Results:
- The PCR-EIA identified Chlamydia pneumoniae in 11.1% of immunocompromised patients (12 out of 108).
- No healthy volunteers tested positive using the PCR-EIA.
- A total of 18.5% of patients showed laboratory evidence of C. pneumoniae infection when combining PCR-EIA and serology.
Conclusions:
- PCR-EIA provides a more rapid and reliable diagnosis of acute Chlamydia pneumoniae infection than culture or serology.
- Serological responses can be undependable in immunocompromised individuals.
- Chlamydia pneumoniae should be considered in the evaluation of pneumonia in immunocompromised patients, given its 11.1% infection rate by PCR-EIA.